Injectable Hyaluronic Acid Gel

[Iguana Senior Member Find all posts View Profile Close Iguana]

First off, let me start by saying that I am posting this is just for discussion.

I have made it no secret in saying that I am a firm believer that Chemical PE will one day make all other avenues obsolete. Manual exercises definitely have their place and I am still an avid practitioner. But, let's face it, it takes many years to make substantial gains and the process is slow and tedious and easy to give up on.

On the other hand, surgery is just plain scary. Not to mention expensive.

Anyway, while reading up on some chemical alternatives I came across a couple of interesting articles. Just in case the links go dead I am posting the articles in their entirety. Again, I am posting this simply for information purposes and I am by NO MEANS encouraging anyone to run out and try this.

In a nut shell they involve using injectable hyaluronic acid gel, a dermal filler commonly used in facial applications to enlarge the glans penis and shaft (Perlane®, Q-Med, Upssala, Sweden, Juveni, Restylan) Hyaluronic acid is a naturally occurring substance in your skin that helps to provide fullness, and elasticity.

The fillers are comparatively inexpensive compared to surgical options and appear to be readily available online without a prescription or medical affiliation. I never proceeded as far as an actual order so this is assumed at this point.

They are injected subcutaneously and appear to be very safe. The effects last from 3-5 years.

Here are the articles. They are rather long so I will post them separately and individually:

[Iguana Senior Member Find all posts View Profile Close Iguana]

Effects of Glans Penis Augmentation Using Hyaluronic Acid Gel for Premature Ejaculation


J.J. Kim; T.I. Kwak; B.G. Jeon; J Cheon; D.G. Moon
Int J Impot Res 16(6):547-551, 2004. © 2004 Nature Publishing Group

Posted 12/16/2004



Abstract and Introduction

Abstract

The main limitation of medical treatment for premature ejaculation is recurrence after withdrawal of medication. We evaluated the effect of glans penis augmentation using injectable hyaluronic acid (HA) gel for the treatment of premature ejaculation via blocking accessibility of tactile stimuli to nerve receptors. In 139 patients of premature ejaculation, dorsal neurectomy (Group I, n=25), dorsal neurectomy with glandular augmentation (Group II, n=49) and glandular augmentation (Group III, n=65) were carried out, respectively. Two branches of dorsal nerve preserving that of midline were cut at 2 cm proximal to coronal sulcus. For glandular augmentation, 2 cc of HA was injected into the glans penis, subcutaneously. At 6 months after each procedure, changes of glandular circumference were measured by tapeline in Groups II and III. In each groups, ejaculation time, patient's satisfaction and partner's satisfaction were also assessed. There was no significant difference in preoperative ejaculation time among three groups. Preoperative ejaculation times were 89.2±40.29, 101.54±59.42 and 96.5±52.32 s in Groups I, II and III, respectively. Postoperative ejaculation times were significantly increased to 235.6±58.6, 324.24±107.58 and 281.9±93.2 s in Groups I, II and III, respectively (P<0.01). The percentage of postoperative satisfaction in both patient and his partner was 68% (17/25) and 44% (7/16) in Group I, 80% (39/49) and 66% (25/38) in Group II and 75% (49/65) and 62% (32/52) in Group III, respectively. Maximal glandular girth was significantly increased from 9.16±0.59 to 10.95±0.4 cm in Group II and 8.95±0.54 to 11.67±0.71 cm in Group III, respectively. These results suggest that glandular augmentation with injectable HA gel is a safe and effective modality to reduce sensory of glans penis. Long-term follow-up for residual volume and efficacy should be requested to establish its precise therapeutic potentials in premature ejaculation.

Introduction

Current treatment choice for premature ejaculation is medical treatment. The main limitation of medical treatment for premature ejaculation is recurrence after withdrawal of medication. Patients with primary premature ejaculation have penile hypersensitivity, which provides further implications for an organic basis of premature ejaculation.[1] In hypersensitivity of glans penis, various topical agents were applied, but the efficacies are still controversial. Dorsal neurectomy is also created to decrease the sensitivity of glans penis.[2] Dorsal neurectomy is not an established treatment of penile hypersensitivity ejaculation due to the uncertain pathophysiology, invasiveness and side effects, for example, numbness paresthesia, pain for neuroma, Peyronie's disease and even erectile dysfunction. Despite these limitations, dorsal neurectomy is still performed in selective patients who do not respond to conventional treatment of premature ejaculation. Major contributing factors of sensory in glans penis are distribution of dorsal nerve, number of receptor, threshold of receptor and accessibility of stimuli to the receptor. Creation of barrier by bulking agent that inhibits the tactic stimuli to reach receptor may be effective in premature ejaculation. In the last decade, hyaluronic acid (HA) has been shown to possess many properties that suggest its value in several medical applications, particularly in ophthalmology, orthopedics, and soft-tissue augmentation with proven efficacy and safety.[3,4,5] Recently, we also reported the feasibility of injectable HA gel in augmentation of glans penis in vivo.[6] We performed this study to evaluate the effect of glans augmentation using injectable HA gel (Perlane®, Q-Med, Upssala, Sweden) for the treatment of premature ejaculation via blocking accessibility of tactile stimuli to nerve receptors.

Materials and Methods

Patients

In all, 139 patients of primary premature ejaculation were recruited to this study. In 25 patients of Group I, dorsal neurectomy was carried out. In Group II of 49 patients, dorsal neurectomy with glandular augmentation using injectable HA gel was carried out. In 65 patients of Group III, glans penis augmentation by injectable HA gel was carried out.

Dorsal Nerve Neurectomy

Under local anesthesia with 1% lidocaine, circumcised incision was made at 2 cm proximal from coronal sulcus. Dorsal branch of dorsal nerve was cut at one side and lateral branch and ventral branch of the other side were cut under magnification.

Glans Penis Augmentation Using Injectable HA Gel

Under local anesthesia, 30 min after topical application of anesthetic cream Emla® (lidocaine 25 mg, prilocaine 25 mg, Astra Xeneca), 2 cc of injectable HA gel (Perlane®, Q-med, Uppsala, Sweden) was injected via 27-gauge needle. Injection needle was indwelled subcutaneously at proximal one-third from tip of glans to coronal sulcus; thereafter, HA gel was injected by Fan technique (Figure 1). After injection of Perlane®, undulation of glandular surface was supplemented by injection of Restylane®(Hyaluronic acid gel, Q-med, Uppsala, Sweden) via 30-guage needle. Both Restylane® and Perlane® are injectable HA gel and have the same composition of 20 mg/ml of stabilized HA gel. The difference between the products is the size of the gel particles. The molecular weight of HA in its pure form can be determined. However, HA in its pure form is not stabilized. Injectable HA gel is chemically modified HA product to increase its longevity in the tissue and to form a gel. It is not relevant to talk about molecular weight, as it cannot be determined for a stabilized gel. Approximate number of gel particles is 100 000/ml in Restylane® and 1000/ml in Perlane®, respectively. For this reason, Q-med recommends 30-guage needle to inject Restylane® into the mid to upper part of dermis and 27-guage needle to inject Perlane® into the deep layer of the dermis.





Figure 1. Injection needle was indwelled subcutaneously at proximal one-third from tip of glans to coronal sulcus; thereafter, HA gel was injected by Fan technique.
Evaluation

At 6 months after each procedure, ejaculatory latency, vibratory threshold of glans penis using a biothesiometer (Bio Medical Instrument Co., USA), patient's satisfaction and partner's satisfaction were compared, respectively. In Groups II and III, changes of glandular diameter were measured by tapeline to compare the net increase of maximal glandular circumference after augmentation of glans penis. Patient's subjective visual estimation of glandular size was requested to assess the residual volume of implants. The patients estimated the visual analogue scale from Grades 0 to IV: Gr 0, no residual volume; Gr 1, less than 25% of initial volume; Gr 2, less than 50%; Gr 3, less than 75%; Gr 4, more than 75% or nearly same as initial volume, respectively. Patient's satisfaction was also evaluated from Grades 0 to 4: Gr 0, very dissatisfied; Gr 1, moderately dissatisfied; Gr 2, about equally satisfied and dissatisfied; Gr 3, moderately satisfied; Gr 4, very satisfied, respectively. Partner's satisfaction was also evaluated by telephone survey. Any adverse reactions were also evaluated.



Results

The mean age of patients was 43.2 (25-67) y in Group I and 41.8 (28-70) y in Group II, 42.1 (27-66) in Group III, respectively (Table 1). In all groups, postoperative ejaculatory latency and vibratory threshold were significantly increased compared to preoperative value (Table 1). There were no significant differences of ejaculatory latency and vibratory threshold among three groups. Maximal glandular circumference was significantly increased compared to basal circumference of 9.16±0.59 cm in Group II (P<0.01) and 9.95±0.54 cm in Group III (P<0.01) at 6 months after injection, respectively. The net increase of maximal glandular circumference after glans augmentation was 15.41±0.82 mm in Group II and 16.58±0.85 mm in Group III, respectively (Table 1, Figure 2). There was no significant difference between both groups. In patient's visual estimation of glandular volume after augmentation in Groups II and III, Gr 3 (more than 50% of injected volume) and Gr 4 (more than 75% of injected volume) was 26.5%, 61.2% in Group II and 24.6%, 65.2% in Group III, respectively. The mean grade of visual estimation was 3.49 in Group II and 3.55 in Group III, respectively. There was no significant difference in both groups. The percentage of postoperative satisfaction (Gr 3, 4) was 68% in Group I, 88% in Group II and 75% in Group III, respectively. The mean grade of patient's satisfaction was high in Group II (P>0.05). In Group II, mean postoperative ejaculatory latencies were 358.6 s in satisfied (Gr 3, 4) patients and 293.5 s in dissatisfied (Gr 0, 1) patients, respectively. In Group III, mean postoperative ejaculatory latencies were 331.5 s in satisfied (Gr 3, 4) patients and 288.9 s in dissatisfied (Gr 0, 1) patients, respectively. In Groups II and III, mean postoperative ejaculatory latencies of satisfied patients were significantly higher than those of dissatisfied patients, respectively (P<0.01). In responding partners, postoperative satisfaction of partner was 44% (7/16) in Group I, 66% (25/38) in Group II and 62% (32/52) in Group III, respectively. There was no abnormal reaction in area feeling, texture and color. In most cases, initial discoloration by glandular swelling recovered to normal within 2 weeks in Groups II and III. Postoperative consistency of glans penis was natural without deformity and maintained through 6 months in Groups II and III. There were no signs of inflammation and no serious adverse reactions in all cases of Group III. In five patients of Group I and nine patients of Group II, numbness (6), paresthesia (4), pain for neuroma (3) and Peyronie's disease (1) occurred.




Figure 2. Representative figures of glans penis augmentation using injectable HA gel. Before augmentation, multiple tiny skin fold and smooth indentation from the tip of glans to proximal glans are clearly seen in dorsal view (a). After augmentation, indentations at the back of glans are elevated and skin folds are disappeared in dorsal view (b) and lateral view (c).



Discussion

Injectable soft-tissue substitutes provide an affordable, nonsurgical alternative for correcting contour defects and soft-tissue augmentation. Several materials have been used for this purpose, including paraffin, silicone and collagen.[7,8] Paraffin and silicone create intense foreign body reactions and are known to migrate from injection sites. Collagen includes rapid degradation, which necessitates frequent reinjection and infrequent but significant hypersensitivity reactions.[9] In recent years, implant materials have also been found to migrate to the lung and the brain.[10] It is therefore advantageous to use degradable materials. The ideal filling substance for soft-tissue augmentation should be biocompatible, nonantigenic, nonpyrogenic, noninflammatory, nontoxic, easy to use, stable after injection, nonmigratory, long lasting but reabsorbable, natural looking and not too expensive.[11,12]
A ubiquitous component of all mammalian connective tissue, HA (hyaluronan) is a naturally occurring polysaccharide, in the same chemical and molecular composition in all species; in the intercellular matrix of dermal layers of the skin of all species, therefore, it is highly biocompatible to use animal sources in humans without creating foreign body reactions.[13,14,15] The material used in this study is based on HA, which has already been used in its native form as an implant for more than 20 y and in millions of individuals without causing adverse reactions. In this study, there were no serious adverse reactions in all cases.

Although the efficacy of HA was proved in various fields, the existence of potential space, technical feasibility and long-term residence should be identified to use injectable HA gel in augmentation of glans penis. Previously, we reported the feasibility of glans penis augmentation by injectable HA in animal experiment.[6] In our study, HA gel was easily injected into the Beagle dogs via 27-guage needle for elastic glans and showed long-term residence in the lamina propria. In this human study, it was not so difficult to inject HA into the dermis of glans penis. The nature of human glans penis is elastic and we developed the Fan technique. Most surgeons are already familiar with this technique, which is frequently used to make subcutaneous bulla for skin test of hypersensitivity and for easy dissection of subcutaneous tissues. In our animal study, we already revealed the potential space of lamina propria in glans penis. Although the long-term residual volumes were not measured, the implants were well maintained until 1 y in this study. We used five-grade scale system. For more accurate estimation of glandular volume, 10-grade scale may be useful, but 10-grade scale is more demanding for patients. Through five-grade scale, patient's self-estimation of long-term residence was fairly good in both groups. The slow digestion of this gel shows that stabilization of the material through crosslinkage is able to increase its longevity several 100 folds compared to the natural polymer, without decreased biocompatibility. The implant has a property of degradation, but has a characteristic of isovolemic degradation. The isovolemic degradation keeps the gel always in balance with water in the tissue, and this increased capacity to bind water of a less concentrated hyaluronan network allows maintaining the correction even in low concentrations of the materials. Another advantage is easy supplementation by reinjection in cases of long-term volume loss. Like other fields of soft-tissue augmentation, there was no serious adverse reaction in this study. There was no abnormal reaction in area feeling, texture and color. In most cases, initial discoloration by glandular swelling recovered to normal within 2 weeks. In most patients, local application of anesthetic cream was sufficient, but a few presented penile pains.

Hypersensitivity of glans penis as a cause of premature ejaculation is still controversial. The skin of human phallus is innerevated by the dorsal nerve of the penis (DNP). The main trunk of DNP is composed of two different populations of axons.[16] The first group traveling along the dorsal midline and terminating in the glans. The other group of fibers radiated from the main trunk over the lateral and ventral aspects of the penile shaft with branches to the corpus spongiosum and urethra. At 1-2 cm proximal to the corona glandis, the DNP dorsal trunk divided into two to three nerve bundles. The DNP and its branches along the shaft run just beneath the skin and fascia, the main branches within the glans are 3-6 mm from the epithelial surface. The extent of nerve fibers, including in dorsal neurectomy, is important in postoperative sensory of glans penis. To avoid excessive sensory loss, dorsal branch at one side and ventral and lateral branches on the other side were excised in this study. Despite our efforts, numbness (6) and paresthesia (4) developed in 10 of 74 patients with dorsal neurectomy, while no patients presented senory loss in 65 patients of glandular augmentation alone. Halata and Munger[17] studied the sensory of the human glans penis. The human glans penis is covered by stratified squamous epithelium and a dense layer of connective tissue equivalent to the dermia of typical skin The papillary dermis blends into and is continuous with the dense connective tissue forming the tunica albuginea of the corpus spongiosum of the glans penis. The most numerous nerve terminals are free nerve endings present in almost every dermal papilla, as well as scattered throughout the deeper dermis. Genital bulbs are present throughout the glans, but are most numerous in the corona and near the frenulum. Considering the studies of Yang[16] and Halata,[17] injectable implants can be successfully injected into the dermis of glans penis just above the nerve terminal. In this study, injectable HA gel was easily injected into the dermis of glans and effectively decreased the sensory of glans penis. However, implants were not injected into the frenulum and corona glandis due to technical difficulty. In this study, the authors anticipated the additive effect of neurectomy with augmentation as measured by postoperative ejaculatory latency. In some patients, additive effects were seen but postoperative ejaculatory latency of Group II was not significantly different from those of Groups I and III. It maybe presumed that each neurectomy or glandular augmentation alone was enough to decrease glandular hypersensitivity. In each group, postoperative ejaculatory latency of satisfied patients was significantly higher than those of dissatisfied patients. Glans penis augmentation has additional benefit in premature ejaculation. The increased self-esteem and self-confidence from enlarged glans may act positively. Our study shows that dorsal neurectomy is effective in selective patients of premature ejaculation. However, major limitations are invasiveness, side effects and possibility of further sensory loss in longer period. Glans penis augmentation by injectable HA gel is not harmful and as effective as dorsal neurectomy in decreasing sensory of glans penis.





Conclusion

These results suggest that glandular augmentation with injectable HA gel is a safe and effective modality to reduce sensory of glans penis. Augmentation of glans penis is a promising treatment for hypersensitivity of glans penis in premature ejaculation patients. Long-term follow-up for residual volume and efficacy should be requested to establish its precise therapeutic potentials in premature ejaculation.

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Tables

Table 1. Characteristics and Parameters of All Patients






References

Xin ZC et al. Penile sensitivity in patients with primary premature ejaculation. J Urol 1996; 156: 979-981.
Tullii RE, Guillaux CH, Vaccari R, Ferreira R. Premature ejaculation-selective neurectomy: a new therapeutic technique-base, indications and results. Int J Impot Res 1994; 6: 109-113.
Olenius M. The first clinical study using a new biodegradable implant for the treatment of lips, wrinkles, and folds. Aesth Plast Surg 1998; 22: 97-101.
Duranti F et al. Injectable hyaluronic acid gel for soft tissue augmentation. Dermatol Surg 1998; 24: 1317-1325.
Goa KL, Benfield P. Hyaluronic acid. A review of its pharmacology and use as a surgical aid in ophthalmology, and its therapeutic potential in joint disease and wound healing. Drugs 1994; 47: 536-566.
Moon DG, Kwak TI, Kim JJ, Cho HY. Effects of hyaluronic acid gel in penile augmentation. Int J Impot Res 2002; 14(Suppl 3: S40.
Burton JL, Cunliffe WJ. The subcutaneous fat. In: Rook A, Wilkinson DS, Champion RH, Ebling FJG, Burton JL (eds) Textbook of Dermatology. Blackwell: Oxford, 1986, pp 1870-1871.
Knapp TR, Kaplan EN, Daniels JR. Injectable collagen for soft tissue augmentation. Plast Reconstruct Surg 1977; 60: 898-905.
Comper WD, Laurent TC. Physiological function of connective tissue polysaccharides. Physiol Rev 1978; 58: 255-315.
Selmanowitz VJ, Orentreich N. Medical-grade fluid silicone: a monographic review. J Dermatol Surg Oncol 1977; 3: 597-611.
Elson ML. Soft tissue augmentation. A review. Dermatol Surg 1995; 21: 491-500.
Pollack SV. Silicone, Fibrel, and collagen implantation for facial lines and wrinkles. J Dermatol Surg Oncol 1990; 16: 957-961.
Larsen NE et al. Hylan gel biomaterials: dermal and immunologic compatibility. J Biomed Mater Res 1993; 27: 1129-1134.
Richter W. Nonimmunogenicity of purified hyaluronic acid preparations tested by passive cutaneous anaphylaxis. Int Arch Allergy Immunol 1974; 47: 211-217.
Richter W, Ryde E, Zetterstrom EO. Nonimmunogenicity of purified sodium hyaluronate preparation in man. Int Arch Allergy Immunol 1979; 59: 45-48.
Yang CC, Bradley WE. Neuroanatomy of the penile portion of the human dorsal nerve of the penis. Br J Urol 1998; 82: 109-113.
Halata Z, Munger B. The neuroanatomical basis for the protopathic sensibility of the human glans penis. Brain Res 1986; 371: 205-230.
Reprint Address

Correspondence to: DG Moon, MD, Department of Urology, Korea University Ansan Hospital, 516, Gojan-dong, Danwon-ku, Ansan-city, Kyunggi-do 425-707, Korea. E-mail: [email protected]


J.J. Kim, T.I. Kwak, B.G. Jeon, J Cheon and D.G. Moon, Department of Urology, Korea University College of Medicine, Sungbuk-ku, Seoul, Korea

Effects of Glans Penis Augmentat

[Iguana Senior Member Find all posts View Profile Close Iguana]

Int J Impot Res. 2003 Dec;15(6):439-43.
Human glans penis augmentation using injectable hyaluronic acid gel.
Kim JJ, Kwak TI, Jeon BG, Cheon J, Moon DG.

Department of Urology, Korea University College of Medicine, Anam-dong, Sungbuk-ku, Seoul, Korea.
Abstract
Although augmentation phalloplasty is not an established procedure, some patients still need enlargement of their penis. Current penile augmentation is girth enhancement of penile body by dermofat graft. We performed this study to identify the efficacy and the patient's satisfaction of human glans penis augmentation with injectable hyaluronic acid gel. In 100 patients of subjective small penis (Group I) and 87 patients of small glans after dermofat graft (Group II), 2 cm(3) of hyaluronic acid gel was injected into the glans penis, subcutaneously. At 1 y after injection, changes of glandular diameter were measured by tapeline. Patient's visual estimation of glandular size (Gr 0-4) and patient's satisfaction (Grade (Gr) 0-4) were evaluated, respectively. Any adverse reactions were also evaluated. The mean age of patients was 42.2 (30-70) y in Group I and 42.13 (28-61) y in Group II. The maximal glandular circumference was significantly increased compared to basal circumference of 9.13+/-0.64 cm in Group I (P<0.01) and 9.49+/-1.05 cm in Group II (P<0.01) at 1 y after injection. Net increase of maximal glandular circumference after glans augmentation was 14.93+/-0.80 mm in Group I and 14.78+/-0.89 mm in Group II. In patient's visual estimation, more than 50% of injected volume was maintained in 95% of Group 1 and 100% of Group II. The percentage of postoperative satisfaction (Gr 4, 5) was 77% in Group 1 and 69% in Group II. There was no abnormal reaction in area feeling, texture, and color. In most cases, initial discoloration by glandular swelling recovered to normal within 2 weeks. There were no signs of inflammation and no serious adverse reactions in all cases. These results suggest that injectable hyaluronic acid gel is a safe and effective material for augmentation of glans penis.

PMID: 14671664 [PubMed - indexed for MEDLINE]

Human glans penis augmentation using injectable hy... [Int J Impot Res. 2003] - PubMed result

[Iguana Senior Member Find all posts View Profile Close Iguana]

Shaft Injections...


ABSTRACT
Introduction.  Despites the debates on penile girth enhancement (PGE), demands for enhancement are increasing. Recently, various fillers have been widely used for soft tissue augmentation with proven efficacy and safety.

Aims.  To identify the feasibility and efficacy of PGE by injection of filler.

Methods.  Fifty patients with subjective small penis who visited Korea University Guro outpatient clinic were enrolled and prospectively followed. Restylane Sub-Q (Q-med, Upssala, Sweden) was injected into the fascial layer of penile body via 21G cannula with “Back & Forth Technique” and homogenized with a roller.

Main Outcome Measures.  From April 2006 to February 2008, 50 patients were enrolled and 41 patients were followed until 18 months after PGE. Changes in penile girth at midshaft were measured by tapeline at 1 and 18 months. Patient's visual estimation of residual volume (Gr 0–4), patient's satisfaction (Gr 0–4), and any adverse reactions were also evaluated.

Results.  Mean injected volume was 20.56 cc (18–22). Compared with basal girth of 7.48 ± 0.35 cm, maximal circumference was significantly increased to 11.41 ± 0.34 cm at 1 month (P < 0.0001) and maintained as 11.26 ± 0.33 cm until 18 months. In patient's visual estimation, two patients complained the decrease as Gr 3 with focal depression at 1 month. At 18 months, all patients answered as Gr 4 without asymmetry. Patient's and partner's satisfaction score was 3.71 ± 0.46 and 3.65 ± 0.48 at 1 month and 3.34 ± 0.53 and 3.38 ± 0.49 at 18 months. There were no inflammatory signs or serious adverse reactions in all cases.

Conclusions.  Considering the property of material, methods, and follow-up results of 18 months, PGE using filler is a very effective and safe technique for penile augmentation. Kwak TI, Oh MM, Kim JJ, and Moon DG. The effects of penile girth enhancement using injectable hyaluronic acid gel, a filler. J Sex Med **;**:**-**.

The Effects of Penile Girth Enhancement using Injectable Hyaluronic Acid Gel, a Filler - Kwak - 2010 - The Journal of Sexual Medicine - Wiley Online Library

[chilee5 Junior Member Find all posts View Profile Close chilee5]

acid

wot site can you buy hyaluronic acid,i am curious about this,would like to know what they say.

[Iguana Senior Member Find all posts View Profile Close Iguana]

There are several sites out there... I saw some that said no prescription needed. I found one that had 100 grams for about $1000.
The average gain in the last article where the entire shaft was injected was 1.6"
I would gladly pay $1000 to increase my girth 1.6" for 3-5 years.

I am definitely looking into this.

[RockstarParkingDude Senior Member Find all posts View Profile Close RockstarParkingDude]

interesting stuff. i agree with you that chemical pe is probably the real solution, but i dont know about this filler thing. it sounds too much like doing plastic surgery on yourself for my liking.

i think the solution is going to come in the form of a chemical cocktail that will allow you to make 1-2 years worth of gains in four to six weeks. i think it probably will have some sort of hormonal aspect (hgh, testosterone, igf1, some sort of peptide) something like viagra or caverject, some sort of vasodialator like arginine, and a vigorous workout routine. i think that there are many defferent avenues that will all add up together to be the real "miracle solution".

till then, i stick with workouts.

[Going411x7 Senior Member Find all posts View Profile Close Going411x7]

Frightening!! The quick fix generation in all its ugliness!!! Yukkkk. Run the other way, men!! Run the other way!!

[Going411x7 Senior Member Find all posts View Profile Close Going411x7]

There are several sites out there... I saw some that said no prescription needed. I found one that had 100 grams for about $1000.
The average gain in the last article where the entire shaft was injected was 1.6"
I would gladly pay $1000 to increase my girth 1.6" for 3-5 years.

I am definitely looking into this.

I have some snake oil I'll sell you for $500, iguana. Are you interested? It works like a charm. You soak your dick in it, and it is guaranteed to make your dick increase in size 2" and it lasts for 8 years--a much better deal. No injections either. Are you interested? The researchers (from Big Dick University) just released their findings.

[RockstarParkingDude Senior Member Find all posts View Profile Close RockstarParkingDude]

boooo.

its not about quick fixes. in my mind its about making it accessible to the general population. How many men here have issues with depression and self loathing, how many have messed up relationships and sold themselves short? how many men aren't on this forum? think about the big picture. this is something that could treat depression among many men better than any amount of prozac. this is something that could change the world if it is studied and researched appropriately. in our modern world we have many ways to better our quality of life, this should be no different.

in my mind it really isn't about quick fixes, its about fitting it into the average young mans overly busy overly stressed life. times are changing and its very difficult to get everything done these days.

[Going411x7 Senior Member Find all posts View Profile Close Going411x7]

Kwak, i.e. quack, is know world-wide for his research. I saw it on-line, God's truth!!!

[Wantmorebulge Member Find all posts View Profile Close Wantmorebulge]

Excellent post iguana.

HA is used by some Harley street cosmetic surgeons for increasing shaft circumference. There was a video I saw a while back of the procedure on a guy with plenty of length but a narrow girth. The results were quite impressive. Unfortunately I am looking for more length rather than girth.

The injections would be done subcutaneously, avoiding the veins, lymph, nerves or passing the fascia. I have not used HA myself, but a colleague of mine uses it as a dermal filler with some great results, and as long as the filler is carefully distributed evenly there shouldn't be any problems.

I would be a little concerned with some people who do not have any anatomical knowledge injecting themselves in their penis. Sterile conditions also are critical as necrotizing fasciitis of the penis is not a good look.

J

[Going411x7 Senior Member Find all posts View Profile Close Going411x7]

It's your body. My body is my temple. I love my glans too much to perform such an act. Back to my yoga.

[Iguana Senior Member Find all posts View Profile Close Iguana]

Interesting points!

I agree completely on the "quick fix" generation. I've never been afraid of hard work or commitment. But, I have been at this over 4 years and have not made any significant gains in almost 2. Unfortunately for me gentlemen, I think I have hit the limit of what manual exercises can do for me. I have to face it, I'm just not gaining anymore.

I would never advocate anyone doing anything that was unsafe or ineffective to themselves. But, let's face it, PE in general carries some inherited risks and injuries do happen. Progress comes from those willing to assume a risk. The first guy to hang weights from his penis probably caught some real crap from others. Either way, I'm not suggesting anyone try this.

However, that's why I threw this out for discussion. People have been using HA safely and effectively for years as dermal fillers.
It is a naturally occruing substance and has been safely used on thousands of faces.

The three articles above show that it can be safely and effectively used for penile augmentation. Am I going to run out and
order some? No, not at this time. But, I will definitley research this further.

As for the injections, I have plenty experience poking my tool with a needle. Plus, I have an extensive understanding of penile
anatomy and structure, so, I would have no reservations sticking myself.

I would be interesting in hearing further from anyone who has knowledge of HA being used in this application.

[Iguana Senior Member Find all posts View Profile Close Iguana]

I have spent the last 5 days reading everything I can find related to this option and have decided to bite the bullet and go for it. It seems to be very safe and the side effects are very mild.

I will initially be doing only the glans but eventually plan on doing the shaft was well. From what I read the filler needs to be placed between buck's fascia and the tunica. I want to make certain I am comfortable with doing that precise of an injection before proceeding with the shaft. The glans is very straight forward and simple.

There are several variants of HA out there, bound to different substances to decrease the absorption rate. I am initially going with one that only last 12-18 months as it is much less expensive. If this endeavor proves successful then I will likely re-administer with a longer lasting one (3 - 5 years.)

I am currently going through a divorce and am not to worried about any issues with symmetry or appearance since I will be the only one seeing it. There is an enzyme known as Hyalurondiase that will dissolve the gel in a worse case scenario.

I have a supplier lined up and am planning on buying 30ml of deep injection grade. I am estimating that I will use 3-5ml on the glans and the remainder on the shaft.

The stuff is a little pricey so I am going to have to put back a little cash for the next few paychecks. I may start a thread with before and after photos to document. Still not sure about this. Don't like the idea of having pictures of my penis on the Internet.
If not, I will still document in detail. I am looking at maybe the 2nd week in Jan.